Mild and moderate cases of small bowel prolapse typically do not need treatment. Surgery may be effective for more significant cases of symptom-causing prolapse. Nonsurgical approaches are available if you're not interested in surgery, if surgery would be too risky or if you want to become pregnant in the future.
Treatment options for small bowel prolapse include:
Nov. 27, 2012
- Observation. If your prolapse causes few or no obvious symptoms, you don't need treatment. Simple self-care measures, such as performing exercises called Kegels to strengthen your pelvic muscles, may provide symptom relief. Avoiding heavy lifting and constipation may reduce the likelihood of worsening your prolapse.
- Pessary. A silicone, plastic or rubber device inserted into your vagina supports the bulging tissue. Pessaries come in a variety of styles and sizes. Finding the right one for you may involve trial and error. Your doctor will measure and fit you for the device, and you'll learn how to insert, remove and clean it.
Surgery. Your surgeon can perform surgery to repair the prolapse through the vagina or abdomen, with or without the use of a robot. During the procedure, your surgeon moves the prolapsed small bowel back into place and tightens the connective tissue of your pelvic floor. Sometimes, small portions of synthetic mesh may be used to help support weakened tissues. Larger pieces of mesh are associated with mesh erosion and generally aren't recommended.
A small bowel prolapse usually doesn't recur. However, further injury to the pelvic floor can happen with increased pelvic pressure, for instance with constipation, coughing, obesity or heavy lifting.
- Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-323-06986-1&eid=4-u1.0-B978-0-323-06986-1..C2009-0-48752-X--TOP. Accessed Oct. 30, 2012.
- Park AJ, et al. Clinical manifestations, diagnosis, and nonsurgical management of posterior vaginal defects. http://www.uptodate.com/index. Accessed Oct. 30, 2012.
- Rogers RG, et al. An overview of the epidemiology, risk factors, clinical manifestations, and management of pelvic organ prolapse in women. http://www.uptodate.com/index. Accessed Oct. 30, 2012.
- Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com/resourceTOC.aspx?resourceID=768. Accessed Oct. 31, 2012.
- Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstetrics & Gynecology. 2012;119:852.
- Hagen S, et al. Conservative management of pelvic organ prolapse. Obstetrics, Gynaecology and Reproductive Medicine. 2012;22:118.
- Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2008. http://www.danforthsobgyn.com. Accessed Oct. 31, 2012.
- Lightner DJ (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 15, 2012.
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